Kids Health Info

Colic crying babies unsettled babies - parent handout

Colic is the word used to
describe when babies cry a lot or fail to settle for a lengthy
period of time. It is now understood that 'colic' refers to the
normal range of unsettled behaviour in many babies; behaviour that can be
very demanding and exhausting for parents.

This crying and fussing can
happen at any time, but often occurs in the late afternoon and early evening, especially in babies between two weeks and four
months of age. It is very common for young infants to have crying
and unsettled times.

This type of normal crying
happens in babies all over the world, in all cultures, and the usual soothing techniques just don't seem to work.

Causes

Medical

Sometimes there is a
medical reason for the baby's crying and this may need to be
checked by a doctor or nurse. This can be very helpful because it
is hard for parents to provide reassurance to their baby if they
are worried there may be a medical problem. However, in most babies
no medical cause is found. Crying is a communication from the baby
to their care giver that they are not comfortable or are
distressed. This is a normal part of their growth and
development.

New
experiences

Newborns have to adapt to a
range of new experiences. They will differ in how sensitive they are
to physical and emotional events inside and outside their
bodies.

Sometimes the causes of the
discomfort may be a wet nappy, being too hot or cold, wind (gas in
their tummy), hunger, tiredness, feeling anxious or unhappy or
needing company. Over time, newborns learn to anticipate what will
help them feel better. For example, a good feed makes hunger go
away, tiredness is fixed by a sleep, a wish for comfort is met by
holding and talking and playing. This process seems to take longer
for some infants who then cry persistently.

Differences

Some babies are easily
frightened by and struggle to cope with normal physical sensations
such as digestion or normal reflux. Others take a long time to
adapt to the world and cope with changes. Many babies are very
tuned in to the emotional world of their family and can be affected
by family distress.

Some babies seem to cry
more than others or to need more soothing than others. This does
not mean there is anything wrong, rather that all babies respond
differently.

Effect on
parents

Parents may also worry that
crying is caused by something they have done and this can sometimes
affect their confidence in handling and looking after their baby.
Maternal depression, family stress, loss or a difficult time
in their own childhood can reduce parents' confidence in
interacting with their baby and make it hard to feel responsive or
playful with their baby.

Parents should be reassured
that a number of things can help them with a baby who is difficult to soothe. The most important is to get family support and talk
to a health professional, such as a Maternal and Child Health Nurse
or the family doctor.

Care at home

Try to stay calm (easier
said than done!) Although you may not be able to stop the crying,
you can help your baby to cope with their distress. It is hard to
think clearly or provide reassurance to your baby if you are
feeling panicky.

Let your baby suck at the
breast or bottle. It may help them to settle for a short period.
Your nurse or doctor can advise you on feeding and the amount of
milk your baby needs.

Offer a dummy.
Sucking may provide comfort and help your baby
to settle.

Try and adopt a
'baby-centred' approach and think from the baby's point of
view.

Remember, you cannot spoil
your baby by too much cuddling or feeding.

Try to select some
soothing strategies that are suited to your infant and use these
regularly so that the baby learns to anticipate what happens when
they are upset.

Gently rock or hold your
baby in your arms or in a baby carrier or sling.

Continue to speak softly
to your baby. Your voice and presence may help soothe
them.

You can try playing some
soft music.

Try giving a warm
bath.

Try a nut- free baby
massage oil. This may calm your baby and also help you to
relax.

The demanding evening time
may be easier if you anticipate that it will happen and plan around it. For example, plan to eat earlier if your baby is often unsettled at dinner time or plan
to carry your baby in a sling at this time.

Some babies seem to need to
be with their mother all the time. Try not to fight this. As your baby develops more confidence, they will learn to self-soothe.
Keep separations to a minimum, try to remain in the baby's view,
carry the baby in a sling or move the baby from room to room in the
pram.

Introduce a doll or teddy,
outside the bassinet or cot, that the baby can look at when
they wake from a sleep so that they do not feel so alone. Have a
photo of you and the baby on the wall at the height that the baby
can see.

Try not to get caught up in
a campaign to get your baby to sleep or to adjust to a rigid
routine. As babies get older they become more alert and stay awake for
longer periods. Their interest in you and the world can help
distract them from what is going on inside their
bodies.

If your baby is in a
playful mood make the most of this time for some enjoyable
interaction for you both.

If possible try and get
support from family and friends. Some mothers find it helpful to
have a short break from the baby so that they can relax. For
others, help with family chores is most useful because then
they can concentrate on comforting their baby. If help is not
available, place your baby safely in their cot and have a few minutes
to relax.

If your baby is crying
for most of the day, it is important to get support and talk to a
health professional (M&CHN, GP, paediatrician, infant mental
health specialist, counsellor) during this difficult
time.

Talk with other parents
about things that have helped them.

Medication

Medication is not
recommended. It may mask illness, interfere with feeding or make
your baby too sleepy.

Medication should only be
used on the advice of a doctor and only for a short period of
time.

Follow-up

See a doctor if:

You need reassurance that there is no medical cause for the crying.

Your baby is refusing
feeds or is having less than half their normal feeds.

Your baby does not seem
to settle with any of the things you are trying.

Your baby continues to
cry for long periods.

You feel you are not
coping.

You feel the crying is impacting on your
relationship with your baby.

You are finding it hard to enjoy your baby
or to feel positive about them.

You feel your mental health or your
relationship with your partner is being affected.

OR you are worried for any other
reason.

Key points to
remember

Being unsettled and
crying is very common in young babies up to four months
old.

Comfort your baby if they
seem distressed.

All babies are different.
Some cry for longer periods and are more unsettled than others.
This is normal.

Try and have breaks from
your child or have an afternoon nap before the early
evening.

Seek help from family and
friends whenever possible.

Sometimes there is a
medical reason for the baby's crying. Most times this is normal
infant behaviour and settles as the baby gets older.

NEVER shake a baby.
Shaking babies even gently can cause brain damage and life-long
disability.

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Disclaimer This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.